Does cognitive function in older adults with hearing impairment improve by hearing aid use?

In the present study, the effects of hearing aid use by hearing-impaired older individuals on different aspects of cognitive function, such as memory, attention, executive functioning, and processing speed, were investigated. Fifty-six participants (mean age = 72.5) who were fitted with hearing aids were compared with 46 control participants (mean age = 74.5) with an equivalent hearing impairment, but who were not fitted with a hearing aid. After a dual baseline measurement and fitting of the hearing aids, all participants were assessed again with neurocognitive tests after 12 months. While the participants with hearing aids had improved aided hearing thresholds, they did not demonstrate an improved performance on the cognitive tests compared to the controls. Thus improved hearing did not improve cognitive functioning. These findings may suggest that hearing aid use only restores impairments at the level of the sensory organ, but does not affect the central nervous system and, as a consequence, cognitive functioning.     

Do you hear the noise? The German matrix sentence test with a fixed noise level in subjects with normal hearing and hearing impairment

Objective: The aim of this study was to determine the relationship between hearing loss and speech reception threshold (SRT) in a fixed noise condition using the German Oldenburg sentence test (OLSA). Design: After training with two easily-audible lists of the OLSA, SRTs were determined monaurally with headphones at a fixed noise level of 65 dB SPL using a standard adaptive procedure, converging to 50% speech intelligibility. Study sample: Data was obtained from 315 ears of 177 subjects with hearing losses ranging from ? 5 to 90 dB HL pure-tone average (PTA, 0.5, 1, 2, 3 kHz). Results: Two domains were identified with a linear dependence of SRT on PTA. The SRT increased with a slope of 0.094 ± 0.006 dB SNR/dB HL (standard deviation (SD) of residuals = 1.17 dB) for PTAs < 47 dB HL and with a slope of 0.811 ± 0.049 dB SNR/dB HL (SD of residuals = 5.54 dB) for higher PTAs. Conclusion: The OLSA can be applied to subjects with a wide range of hearing losses. With 65 dB SPL fixed noise presentation level the SRT is determined by listening in noise for PTAs < ～47 dB HL, and above it is determined by listening in quiet.     

Is hearing preservation feasible with the retrosigmoid approach?

The main advantages of the retrosigmoid approach are fast and good visualization of the brainstem structures and the possibility to remove tumors of all sizes. Hearing preservation, although possible, is not always achieved. The aim of this study is to present our experience with the retrosigmoid approach for acoustic neuroma resection, emphasizing our hearing results. The notes of 56 cases of acoustic neuroma removed through a the retrosigmoid approach were reviewed. Tumor size ranged from 8 to 50 mm (mean 24 mm). Considering patients with preoperative serviceable hearing, postoperative serviceable and measurable hearing was achieved in 13.3% and 26.7% of cases respectively. No tumor recurrence occurred in our series. The retrosigmoid approach is a reliable surgical procedure for most vestibular schwannoma. However, hearing preservation results may be unsatisfactory and show wide differences depending on selection criteria and the hearing terminology used. Concerns about hearing preservation should not be the deciding factor for using this approach.     

The current status of hearing care: can we change the status quo?

The members of the profession of audiology often express concern that the services and products that have been developed to provide benefit to the hearing impaired are not sought after or delivered to the majority of those diagnosed with hearing loss. A critical look at the status quo of hearing care delivery in the United States is needed to verify this assumption and to develop strategies to improve the situation. A key concern is the lack of a comprehensive high-quality scientific database upon which to build continuous improvements in the effectiveness of the services and products that are provided to the hearing impaired.     

Rehabilitation of adult patients with severe-to-profound hearing impairment – why not cochlear implants?

Background: In Sweden, an estimated prevalence of adult patients with severe-to-profound hearing loss is 0.2%, which corresponds to roughly 20,000. We know little about the use of cochlear implants (CIs) in this population and why not most of them are not offered CI.

Objectives: To investigate the reasons for no rehabilitation with CI among this patient group.

Materials and methods: Data were collected from 1076 patients in the Swedish Quality Register of Otorhinolaryngology. A baseline questionnaire and the reason for no CI, was evaluated.

Results: Only 14.5% of the patients started a CI investigation, and 8.5% were rehabilitated with CI. Significantly more women (56.5%) than men received CI. The most common reasons for not receiving CI, were hearing reason (30.5%), indicating satisfaction with technical equipment, and unknown reason (25%). The oldest patient group (81–100 years old) had the highest risk for unknown reasons. Patients receiving extended audiological rehabilitation (53.5%) had a significantly lower risk for unknown reasons.

Conclusions: It is worrying that the oldest patient group (81–100 years old) seemed to have fewer chances to start a CI investigation. An extended audiological rehabilitation increased the chances that professionals would discuss CI.

Significance: This study shows that surprisingly few patients are offered CI despite their severe-to-profound hearing loss.     

How common is hearing impairment in osteogenesis imperfecta?

Hearing impairment has long been recognized as a common feature in osteogenesis imperfecta. The figures in some publications could be taken to imply that, with increasing age, the proportion of osteogenesis imperfecta patients with hearing impairment approaches 100 per cent. The incidence of hearing loss in a large survey of 1394 patients with osteogenesis imperfecta was examined. It was found that the most common age of onset was in the second, third and fourth decades of life. At the age of 50 approximately 50 per cent of the patients had symptoms of hearing impairment; over the next 20 years there was little further increase. Differences were shown between patients with different clinical types of osteogenesis imperfecta as delineated in the Sillence classification; hearing loss was significantly less common in the type IV disease than in the type I disorder. Among the 29 families with osteogenesis imperfecta type IA there were distinct differences in the likelihood of hearing loss. These findings provide insights which will be valuable in giving patients advice on the likelihood of developing hearing loss in the future.     

Patient safety and the annulment of medical clearance exams for hearing aids: Are we “closing the book” too soon?

PurposeTo determine the utility of medical clearance exams by otolaryngologists prior to the distribution of hearing aids to patients with hearing loss.Material and methodsMedical records of 313 consecutive hearing-impaired individuals seeking financial assistance for hearing aids from the Lions Hearing Center of Michigan and who presented for medical clearance exams between January 2014 and May 2017 were retrospectively analyzed. Separate determinations were made for each patient about (1) benefit from the exam and (2) avoidance of significant harm.ResultsMajority (64.2%; n = 201) of patients benefited from medical clearance exams. Furthermore, 5.4% of patients (n = 17) were found to have avoided significant harm due to administration of the medical clearance exam. Finally, 14.4% (n = 45) were offered alternative interventions over conventional hearing aids.ConclusionsMedical clearance exams are beneficial to a majority of patients with hearing loss prior to receiving hearing aids. With the impending arrival of over-the-counter hearing aids in the United States, special consideration should be placed on educating the general public about the importance of the medical evaluation prior to purchasing any type of hearing aid.     

Early detection of hearing impairment in a developing country: what options?

The concept of early detection is often predicated on a specified time-interval for optimal neural development in early childhood. This has been facilitated by advances in objective screening methods such as auditory brainstem response (ABR) and otoacoustic emissions (OAE). However, the prospects for this trend in developing countries remain doubtful, because of adverse socio-economic conditions. Consequently, the relative effectiveness of available tests was evaluated to determine the most viable option for mass screening based on findings from a broader study among 359 school entrants (mean age 6.7 years) in Lagos. The specificity of the questionnaire for detecting hearing loss was 94.0 per cent as against 62.4 per cent for otoscopy and 84.0 per cent for tympanometry. The sensitivities for the three methods were 10.0 per cent, 56.0 per cent and 52.0 per cent, while the positive predictive values were 21.7 per cent, 19.4 per cent and 34.6 per cent respectively. Notwithstanding its limitations, the administration of a well-structured questionnaire at school entry, complemented with parental education, may constitute the inevitable and immediate option for an early detection program in a developing country.     

Does having a job improve the quality of life among post-lingually deafened Swedish adults with severe-profound hearing impairment?

The purpose of the present study was to measure health-related quality of life (HRQL), personal harmony and work-induced problems, and to identify typical personal traits among Swedish adults with a severe-profound hearing impairment who were employed full-time. In comparison with hearing people aged <65 years, the hearing-impaired individuals working full-time differed only as regards energy and social isolation. Compared to another group of hearing-impaired subjects (working either part-time or retired) the study group scored better on most dimensions. Personal harmony of the hearing-impaired group working full-time did not differ from that of average employed Swedish people. The work situation of the group was generally reported to be busy but rewarding, especially concerning contact with fellow workers and management. Among various personal traits examined, strong will-power and stress tolerance were the most significant. However, due to the small sample size, it is not possible to state that the results indicate a general situation or were just due to the study subjects constituting an elite sample of hearing-impaired individuals.     

Stem-cell therapy for hearing loss: are we there yet?

IntroductionMammalian hair cells and auditory neurons do not show regenerative capacity. Hence, damage to these cell types is permanent and leads to hearing loss. However, there is no treatment that re-establishes auditory function. Regenerative therapies using stem cells represent a promising alternative.ObjectiveThis article aims to review the current literature about the main types of stem cells with potential for application in cell therapy for sensorineural hearing loss, the most relevant experiments already performed in animals, as well as the advances that have been recently made in the field.MethodsResearch included the databases PubMed/MEDLINE, Web of Science, Science Direct and SciELO, as well as gray literature. Search strategy included the following main terms: “stem cells”, “hair cells” and “auditory neurons”. Additionally, the main terms were combined with the following secondary terms: “mesenchymal”, “iPS”, “inner ear”, “auditory”. The research was conducted independently by three researchers.ResultsDifferentiation of stem cells into hair cells and auditory neurons has a high success rate, reaching up to 82% for the first and 100% for the latter. Remarkably, these differentiated cells are able to interact with hair cells and auditory neurons of cochlear explants through formation of new synapses. When transplanted into the cochlea of animals with hearing loss, auditory restoration has been documented to date only in deafferented animals.ConclusionAdvances have been more prominent in cases of auditory neuropathy, since partial improvement of auditory nerve conditions through cell-based therapy may increase the number of patients who can successfully receive cochlear implants.     

Genetics of hearing loss: where are we standing now?

Hearing loss (HL) is the most common sensory impairment and is caused by a broad range of inherited to environmental causes. Inherited HL consists 50–60% of all HL cases. The inherited form of HL is further classified to different categories. More than 300 syndromes and 40 genes have been identified to result in different levels of HL. Although several diagnostic or screening tests have been developed, yet there are controversies around their use.     

The COCH gene: a frequent cause of hearing impairment and vestibular dysfunction?

The identification of genes leading to hereditary hearing impairment is one of the ways to elucidate the functioning of the inner ear. Over the past few years, several genes responsible for non-syndromal hereditary hearing impairment have been identified. One of these genes, named COCH, is responsible for autosomal dominant progressive sensorineural hearing loss associated with vestibular impairment (DFNA9). Histopathological analysis in patients with a COCH mutation revealed the presence of an acidophylic mucopolysaccharide deposit in the inner ear. An overview of the clinical, pathological and genetic studies on COCH is given, and the possible role of COCH in the pathology of DFNA9 is discussed.